Collection of Blood Flashcards
Physiologic Factors affecting Test Results (6)
- Posture
- Diurnal Rhythm
- Exercise
- Diet
- Stress
- Diet
Large molecules that cannot filter into the tissues (3)
- Protein
- Cholesterol
- Iron
Refers to daily body fluid fluctuations that occur with some constituents of blood
Diurnal Rhythm
Higher in the morning (3)
- Cortisol
- TSH
- Iron
Lower in the morning (1)
- Eosinophils
What can exercise increase? (7)
- Creatinine
- Total Protein
- Creatinine Kinase
- Myoglobin
- Aspartate Aminotransferase
- HDL-Cholesterol
- WBC Count
What can cause a temporary increase in WBC count in children?
Anxiety and Excessive Crying
Smoking can cause?
Increased WBC / Cortisol
Long term smoking can cause?
Decrease Pulmonary Function
Decreased pulmonary Function can result to?
Increased Hemoglobin
Under fasting the exception of water is only for how many hours before a blood draw?
8-12 hours
If patient has eaten recently there is temporary increase in?
Glucose and Lipid
What is increased lipids that can cause turbidity called?
Lipemia
Used to provide a barrier against venous blood flow to help locate vein?
Tourniquet
Tourniquet should be applied _____ above the veni site
3-4 inches
Order of Draw?
- Yellow
- Blue
- Red
- Green
- Lavender
- Gray
Blood specimens for serum testing must be allowed to clot first for _____ prior to centri
30-60 mins
Clot activators include ____ or ____ that activates ________ and ______
Glass or Silica Particles
F7 and Thrombin
Removes calcium by forming insoluble calcium salts (3)
- EDTA
- Citrate
- Oxalate
Prevents clotting by binding to antithrombin and inhibiting thrombin
Heparin
This inhibits metabolism of glucose by blood cells and what is the color of the tube?
Anti-glycolytic Agent / Gray
Most frequently used anti-glycolytic agent?
Sodium Fluoride
An inert material that undergoes a temporary change in Viscosity
Gel Separator
_____ the gauge number, the _______ the bore
Smaller / Larger
Most common needle size for adult veni?
21 gauge
Useful in collecting specimens for children or older patients
Winged Blood Collection Set
Useful in collecting specimens for children or older patients
Winged Blood Collection Set
Most common skin antiseptic
70% Isopropyl Alcohol
For Blood Culture, What is included in the 2-step procedure?
- 30-60 secs rub with alcohol
- 1%-10% Povidone-Iodine pads
Whare is the most common site for venipuncture?
Antecubital Fossa
2 Anatomical Patterns of veins
- H Pattern
- M Pattern
Veins under H pattern?
- Median Cubital Vein
- Cephalic Vein
- Basilic Vein
Veins under M Pattern
- Median
- Accessory Cephalic Vein
- Basilic Vein
Why is Basilic Vein the last choice?
Closest to brachial artery
What finger do you use to palpate vein?
Index
Ratio of blood to anticoagulant?
9:1
Gauge for children?
22-23
Complications (10)
- Ecchymosis
- Hematoma
- Fainting
- Hemoconcentration
- Hemolysis
- Petechiae
- Allergies
- Nerve Damage
- Seizures
- Vomiting
Leakage of small amount of blood in tissue around puncture site
Ecchymosis
Leakage of large amount of blood around the puncture site causes the area to rapidly swell
Hematoma
What does CLSI not recommend to use for the revival of patients ?
Ammonia
Increased concentration of cells, larger molecules and analytes in the blood
Hemoconcentration
Rupture of red cells with consequent escape of Hgb
Hemolysis
Small red spots indicating small amounts of blood have escaped into the skin
Petechiae
Symptoms of Nerve Damage?
- Sharp Pain
- Tingling
- Numbness in the arm
Venipuncture in Special Situations (5)
- Edema
- Obesity
- Burned, Damaged, Scarred and Occluded veins
- IV Theraphy
- Mastectomy Patients
Technique of choice to obtain blood specimen from newborn and pediatric patients
Skin Puncture
Skin puncture is for what type of patients? (3)
- Adults that are severely burned
- Obese Patients
- Elderly Patients with Fragile Veins
Blood from skin puncture closely resembles ______
Arterial Blood
This can increase blood flow sevenfold
Warming Site
Heel warmer or Warm washcloth temperature and time
<42°C / 3-5 mins
Povidone-Iodine in skin puncture can cause?
False Increase (K+, P & Uric Acid)
Puncture site of Skin Puncture for Heel
Lateral Side of Heel / Medial Side of Heel
Heel puncture depth
<2 mm deep
Bone infection from heel puncturr
Osteomyelitis
Do Not puncture _____ ,_____ , _____ area
- Swollen
- Bruised
- Infected
Do not perform skin puncture in patients with?
- Edema
- Dehydration
- Poor peripheral circulation
Order of Draw for Skin Punture
- Blood Gas Analysis
- Slides
- EDTA
- Other tubes
- Serum Tubes
Reasons for Specimen Rejection (8)
- Unmatched form and label
- Unlabeled Tube
- Hemolyzed Sample
- Wrong collection time
- Wrong Tube used
- Clotted specimen
- Contaminated with intravenous fluid
- Lipemic Sample